1409

means of passing fluid into the middle-ear, and of Hay’spharyngoscope, of which the use is advocated.

Deformities of the external ear, followed by injuries of theauricle and external auditory meatus, form the subject of thenext two chapters. Chapter VIII., on diseases of the auricle,is well illustrated by figures of sections of various new

growths, and also contains lucd descriptions of diseases

affecting the auricle, with their appropriate treatment.

Foreign bodies in the ear and diseases of the external

auditory meatus occupy the next two chapters. One of the

plates shows three forms of parasite occasionally found

growing in the ear. This illustration is extremely wellexecuted.The anatomy of the middle-ear is fully described andillustrated in Chapter XI. Catarrhal otitis media in its

acute and chronic forms, with their complications andsequelæ, is ably dealt with in the fourteenth and fifteenthchapters. Acute and chronic suppurative otitis media and theappropriate treatment occupy the succeeding two chapters.In Chapter XIX. one finds a mine - of information in

’reference to the Bacteriological Examination of Discharges.This is a branch of the subject with which boththe writers’ names are intimately associated, and not

only does the account contain all the information that has

gradually been made known, but, coming as it does fromthe source of the information itself, it is particularlyvaluable and interesting. Aural polypi, cholesteatoma,and tuberculous diseases of the middle ear form the

subjects of the next two chapters. Of these, the last

has been associated with the name of Dr. Milligan as

one of its earliest and most earnest investigators, for manyyears.

In Chapter XX. disease of the mastoid process with allits accompanying sequelæ, and the proper methods of

dealing therewith, are carefully and clearly enumerated. ITinnitus, its differential diagnosis and treatment, forms

the subject matter of Chapter XXVIII. The next three

chapters are devoted to intracranial lesions secondary toaural diseases, both the text and the illustrations beingextremely clear, and the descriptions, especially of the

operations, leaving nothing to be desired.The thirty-second chapter deals with the anatomy of theinternal ear. Disease of the labyrinth is dealt with in

Chapter XXXIII., and all that is known at present on thismatter is given. Oto-sclerosis is ably dealt with in a subse-quent chapter, which is followed by one on inflammatorydiseases of the labyrinth. Amongst the later interestingchapters one finds references to diseases of the ear

in relation to general medicine, deaf-mutism, and aural

disease and life insurance, while diseases of the nose,

naso-pharynx, and pharynx, especially liable to involvethe organ of hearing, fittingly occupy the concludingchapters.This book is one the perusal of which has proved a source

of great pleasure. Although it is no small work, yet thereis- nothing we would wish omitted, and we have not dis-covered the omission of anything which should have beenincluded. The diction is easy and the descriptions are plain ;the illustrations are excellent and the printing is good. Dr.

Milligan- and Dr. Wingrave have given us the most com-prehensive work on diseases of the ear which has been

published in the British Isles, and it is one which, althoughprofessedly for senior students and practitioners, will doubt-less , be found equally welcome by those who deal

more especially with aural surgery. It is extremeleygratifying that the authors have been able to quote so freelyfrom,the work of their British colleagues, while they them-selves give a practical demonstration of the progress ofBritish otology.

JOURNALS AND MAGAZINES.

The Journal oj Physiology. Edited byJ. N. LANGLEY, Sc.D.,F.R.S. Vol. XLIII., Nos. 1 and 2. Cambridge UniversityPress : C. F. Clay. Sept. llth and Oct. 20th, 1911. Price

6s. 6d. and 7s.-The first paper, by Harriette Chick andC. J. Martin, on Heat Coagulation of Proteins, is a continua-tion of a previous paper (Jli1trnal of Physiology, vol. xl.,1910). " Heat coagulation " of egg-albumin consists of twoprocesses : (1) the reaction between the protein and hot water(" denaturation"), and (2) the separation of the altered

protein in a particulate form (agglutination). The rate of

(2) was arranged to be greatly in excess of that of (1) in theexperiments, so that (1) is the limiting factor in the process.

During the process, as protein is precipitated, free acid is

progressively removed from the solution. The extra amount

of acid fixed by egg-albumin in coagulation was determinedand its cause explained. The coagulate rate is lowered bythe presence of salts, e g., NaOl and Am2SO4. Theshort paper by F. O’B. Ellison, The Relation betweenthe Physical, Chemical, and Electrical Properties of the

Nerves, Part V., The Action of Cinchonamine Hydro-chloride on Frog’s Nerve, is the fifth of the series,and is chiefly interesting to physiologists, as it dealswith the specifically different action of cinchonamine hydro-chloride on the injury current and on the negativevariation of frog’s nerve. Arthur Harden and HughMaclean’s paper on the Oxidation of Isolated Animal Tissues

is a continuation of a previous paper on that abstruse ques-tion. Minced organs and tissues of animals have no more

power of producing carbonic dioxide from sugar when

incubated in an atmosphere of oxygen than they have in anatmosphere of nitrogen or hydrogen. Tissue juices obtainedeither by the kieselguhr, the aqueous, or the saline methodpossess little or no respiratory action. Antiseptics and

grinding the tissues with sand materially lower the oxidationprocesses.

The long communication, over 40 pages, of Keith

Lucas on the Transference of the Propagated Disturbancefrom Nerve to Muscle, with special reference to the

apparent inhibition described by Wedensky, is an elaborateinvestigation of the Wedensky effect (1885)-i.e., the

"apparent inhibition " observed in a muscle excited from itsmotor nerve. The author’s endeavour is to show that this

effect depends for its possibility on a simple property knownto be possessed in high degree by the synapse of the centralnervous system-namely, a resistance to conduction greaterthan that of the continuous axon. The paper is especiallyinteresting to physiologists. In a short paper on the Effect ofStimulation of the Eighth and Ninth Spinal Nerve-roots uponthe Bladder of the Toad, Frank P. Knowlton finds that thearrangement of the autonomic system in the toad is similarto that of the frog ; that stimulation of the eighth nerve-rootproduces no effect on the bladder. No evidence of efferentfibres in the posterior roots was found. H. M. Vernon givesan account of his further investigations on the IndophenolOxidase of Mammalian and Avian Tissues. He finds it to be

most abundant in the heart muscle, whilst the liver, with one

exception, is poorest. The amount of oxidase in varioustissues of the rabbit, cat, and dog roughly corresponds withtheir degree of oxygen saturation, as determined by Ehrlichby his intra vitam staining methods. In birds there is a

close parallel between the oxidasic power of the tissues andthe respiratory exchange. The canary has eight times theC02 output of the goose. The oxidasic power of a tissue

depends largely on its power of sustained activity-e.g., thepectoral muscle in vigorous flying birds is as rich in oxidaseas the heart, and three times as rich as limb muscle, whilein the tame duck pectoral muscle contains scarcely any

x 3

1410

oxidase. In mammals red muscles contain much moreoxidase than white, and tongue and diaphragm most of allnext to the heart. Cold-blooded animals have very little,while in small embryos it is at a minimum, and rapidly in-creases with embryonic development, and for the first fort-

night of post-natal existence. The liver for a week or twoafter birth is richer in oxidase than the adult liver.

In Vol. XLIIL, No. 2, the paper of Mutch and Pembrey onthe Influences of Tetrahydro-B-Naphthaline upon the Tempera-ture and Respiratory Change deals chiefly with the relationof the rise of temperature to muscular activity. The drug,the action of which was first investigated by Stern, causesextreme dilatation of the pupil, constriction of the vesselsof the ear, rapid respiration, restlessness, greatly increasedmuscular activity, spasms, and even convulsions. In fatal

cases death may be due to either hyperthermia, paralysis, orcyanosis with cardiac failure. The increased heat appearsto bear a definite relation to the muscular activity, and isaccompanied by an adequate increase in the intake of oxygenand the output of carbon dioxide. The action of the drugis upon the central nervous system, upon the higher morethan the lower, the increased excitability being accom-panied by increased muscular movement, spasms, and

even convulsions. The rise of temperature, at any rate inthe non-fatal cases, can be explained by the increasedmuscular activity. Convulsions were present in eachcase when death occurred from hyperthermia, a condi-tion favoured by the cyanosis present. The processes ofoxidation and heat production are increased when the tem-perature of an animal is raised above its optimum, so that itis unnecessary to expect a persistence of vigorous muscularmovements during the whole time the temperature is rising.There is a marked antagonism between the drug and anæs-thetics ; in suitable doses it prevents chloral narcosis, andchloral or chloroform will arrest the rise of temperatureproduced by the drug.

Professor Langley’s paper on the Effect of Various Poisonsupon the Response to Nervous Stimuli, chiefly in Relationto the Bladder, is the largest contribution. The experi-ments were made on anaesthetised cats. Starting from hisown observations on the antagonistic action of curari andnicotine upon peripheral nerve cells, the author discussesthe nature of that action. The nerves to the bladder

were exposed-the bladder itself being previously filled witha mixture of normal urine and warm salt solution,so that the bladder could contract under nearly isotonic con-ditions. The sacral nerves were stimulated in pairs ; the

alkaloids were injected into a vein and faradic stimuli wereincreased. Numerous tracings are given to show the effectsor responses obtained. Stimulation of the sacral autonomicfibres affects nerve fibres, nerve cells, and the smooth muscleof the bladder. The author concludes that it is the nerve

cells which are affected by the drug. Stimulation of thesacral nerves, which contain vesico-motor fibres, caused strongcontraction of the bladder, as shown by the curves taken ofvariations of the internal volume of the bladder. If thestimulus is brief relaxation soon sets in ; if the stimulus is

prolonged relaxation sets in more slowly. No clearevidence was obtained of the presence of inhibitoryfibres in the normal condition. After injection of nicotinethe first effect of stimulating the sacral nerve is inhibition.Nicotine stimulates the peripheral nerve cells. There is

antagonism between nicotine and curari and both act on theperipheral nerve cells. When curari or nicotine has been

injected stimulation of any branch of the pelvic plexus,which has pre-ganglionic fibres, causes after-contraction, butstimulation of post-ganglionic fibres on the bladder causesa normal contraction with no after-contraction. We must

refer to the original paper for the remarks of the author,

more especially when he himself says : " I do not think anyfinal conclusions can be drawn as to the cause of the various

phenomena described in the paper." " The paper ofH. H. Dale and P. P. Laidlaw (Wellcome Research

Laboratory) on the Action of Iminazolylethylamine is a

continuation of a previous paper (Journal of Physiology,vol. xli., 1910). The drug causes a vaso-dilator fall ofblood pressure in carnivora and in the monkey and

fowl, and this is due to a direct action of the baseand not to the liberation of a vaso-dilator substance

in the body. It is independent of the integrity of the

peripheral sympathetic neurons, but is not due to directaction on the smooth muscle. It also causes a large andrapid fall of rectal temperature. The note by the sameauthors on reversed action of the chorda tympani on salivarysecretion is interesting. Under certain conditions-after

nicotine, curari, hordenine, tropine-a reversed action of thevagus is possible-i.e., the cat’s heart may be acceleratedduring, and inhibited between the periods of, stimulation,On using cytisine, the alkaloid of laburnum seeds, the

authors obtained a secreto-inhibitory action, instead of theusual excito-secretory effect.

In the short paper communicated by the late Dr. F. W.Pavy and W. Godden on Some Recently Elicited Facts

Relating to Carbohydrate Metabolism and Glycosuria, ex-

periments are given to support Pavy’s contention that sugaris taken from view by the incorporating agency of bioplasm,what is not so dealt with being discharged from the systemwith the urine. The paper by T. Graham Brown and C. S.Sherrington-Observations on the Localisation in the MotorCortex of the Baboon (Papio anubis)-is illustrated withelaborate charts of the cerebral motor areas. The localisa-tion in the motor cortex of the baboon agrees closely withthat found in other simian types examined. As regardsspecialisation, it lies between macacus and the anthropoidtypes. Oa the pre-central gyrus from below up the suo-cessive areas are for lower face, upper face, neck, arm,

chest, abdomen, leg, and perineum. Face movements are

particularly clearly demonstrated. Overlapping of individualrepresentatives in each of these main areas is very marked.The following are some of the titles in the Proceedings ofthe Physiological Society for July 22nd, 1911 :-P. G. Ward:The Study of the Action of Various Salts on Isolated

Muscle ; I., Sodium, Potassium, and Ammonium Salts. B. R.

Macmillan : A New Form of Perfusion Stopcock. CasimirFunk : Note on the Probable Formation of Adrenaline in theAnimal Body. L. Bull: On the Simultaneous Record of thePhono- and Electro-cardiogram. F. W. Edridge-Green : -.Lantern for the Quantitative Estimation of Defects of ColourPerception.

The Archives of the Roentgen Ray under the energeticeditorship of Mr. W. Deane Butcher is a most valuable

periodical. The outstanding feature of the October numberis that of the X ray treatment of malignant disease. The

point of view taken by Professor S. Leduc, of Nantes, is onethat has much to recommend it, and should be widelyread. Dr. Reginald Morton treats the same subject in a verytemperate spirit ; he makes a plea for the more general useof post-operative attention, and points out the feasibility oftreating the operation area before the wound is closed. The

plates in this number are taken from some made in theGeneral Hospital of Birmingham by Mr. J. Hall-Edwardsand Mr. F. Emrys-Jones. Those showing disease and injuryabout the skull are very fine.-The November number, justissued, is also of unusual interest, and contains articlescontributed from France, Germany, and Austria. ProfessorLeduc’s article on Molecular Physics contains some

interesting studies on the phenomena of solution, in con-

tinuance of his fascinating investigations on osmotic growth,

1411

which excited so much interest at the Royal and other learnedsocieties last winter. Professor Albers Schonberg contributesan article on the new Lindeman focus tube, of lithium glass,which promises to be a great advance in X ray tube con-struction. The most interesting paper, however, is that byDr. Guido Holzknecht on the Roentgen Diagnosis of the

Stomach. This is admirably illustrated and contains verydefinite and practical suggestions for the diagnosis of gastricdiseases, as well as a description of Haudek’s simplifiedmethod for the Roentgen examination of the stomach bymeans of a double bismuth meal. The " Notes and

Abstracts " found in each issue are judiciously selected toform a guide to the current literature dealing with the

subjects of the journal itself. The change in size and

arrangement of the °’ Archives," on which we commentedabout a year ago, has rendered this journal much more handyand convenient.

The Medical Chronicle.-In the October issue is pub-lished a thesis by Dr. P. Moran on the PharmacologicalAction of Tincture of Digitalis, with special reference to themode of its preparation and to the effects of age. He con-

cludes that the drug deteriorates with keeping ; possibly thedigitoxin is decomposed. But a reliable preparation madewith 90 per cent. alcohol should remain useful for two orthree years. A second thesis, by Dr. Herbert Tomlin,deals with miners’ nystagmus, which the author attributesto the rhythmical swaying action of using a pickaxe, aidedby the bad illumination and by the optical effects of the

crystalline fracture of the coal.

Edinburgh Medical Journal.-A paper by Dr. A. LoganTurner on the Spread of Bacterial Infections from the Nasaland Naso-pharyngeal Cavities by Way of the LymphaticChannels appears in the November number of this magazine.The author considers that the assumption of a flow of lymphfrom the nose to the brain is improbable, the current, if any,being presumably in the opposite direction. On the other

hand, tubercular infection may be conveyed from the noseto the cervical lymphatic system. Dr. G. Duncan Whytediscusses the causes of the prevalence of pulmonary tuber-culosis in South-east China, and Dr. James Oliver writes onUtero-sclerosis and Sclerosis of the Recto-utero-vesicalFascia.

_______________

Reports and Analytical RecordsFROM

THE LANCET LABORATORY.

(1) ALCOHOLIC EXTRACT OF GUINEA-PIG’S HEART;(2) HÆMOLYTIC SERUM FOR SHEEP’S CORPUSCLES;

AND (3) EPININE FOR OPHTHALMIC USE.

(BURROUGHS, WELLCOME, AND Co., SNOW HILL BUILDINGS, LONDON,E.C.)

1. THE alcoholic extract of guinea-pig’s heart is for useas an antigen in the Wassermann reaction, replacing theextract of syphilitic foetal liver originally used by Wasser-mann. It is an obviously convenient preparation for themodern diagnosis of syphilis, and is obtained by digestingthe finely minced hearts in alcohol and, finally, filtering thefluid. 2. The hasmolytic serum for sheep’s corpuscles is

prepared by inoculating an animal with sheep’s red cor-

puscles. Ultimately the serum of the inoculated animal

acquires the property of hæmolysing sheep’s corpuscles. Asa dilution it can thus be used as a hæmolytic serum inthe Wassermann and other complement deviation tests.3. Epinine, the synthetic substance having a pharmaceuticalaction similar to that of the suprarenal active principle, is now prepared in tabloid form for ophthalmic use. Each

tabloid contains 0 - 006 gramme of epinine. In this formthis valuable haemostatic can be easily applied to the eye.

VITTEL WATER (GRANDE SOURCE).(E. DEL MAR, 12, MARK-LANE, LONDON, E.C.)

Vittel water has enjoyed a reputation in the treatment of .

gout and kidney troubles. It affords the centre of attraction

to the health resort Vittel, an interesting old town situatedto the south-east of Paris and about 70 kilometres from the

German frontier. Recently Vittel has developed considerablyand a new colony has sprung up about half a mile fromthe old town, where hotels and the usual appurtenances ofa health resort have been erected in view of increasingdemands. The environment of New Vittel is attractiveand there are facilities for open-air recreations. The waters

appear to be most beneficial in the treatment of gout andallied disorders, but, like so many other waters, a merechemical analysis does not seem to supply an explanation ofthe practical good obtained by their use. According to ouranalysis, Vittel water from the Grande Source contains about1-836 grammes per litre of mineral salts, and the principalconstituents are the sulphates of lime, magnesia, and soda inapproximately equal quantities. Generally speaking, a waterthat contains sulphates shows radio-activity, and this mayhave something to do with the valuable medicinal propertiesof Vittel water. Then, of course, a strict régime of a courseof water is an advantage in many of the cases which treat-ment at Vittel benefits. The water is, further, alkaline byreason of the carbonates of the alkaline earths present.Apart from the value of the waters in the treatment of

disease, there are provided at Vittel all the essentials of

hydro-therapeutic practice.

PEPTO-MANGAN (GUDE).(AGENCY, THOS. CHRISTY AND CO., 4-12, OLD SWAN-LANE, LONDON,

E.C.)The important ingredients of this preparation are, according

to our analysis, iron and manganese, both of which are inorganic combination. The addition of ammonia produces noprecipitate, but the addition of caustic soda does. The

presence of peptones was confirmed, and the inference is thatiron and manganese occur as peptonates, an admittedlyuseful form of administering these metals where a hæmatinicis indicated (chlorosis, anasmia). There is present also

ammonia, for on heating with soda a strong smell of

ammonia was evolved. The same result is obtained when theammonium citrate of these metals is similarly treated. The

preparation is a clear brown fluid and palatable. Accordingto some clinical reports which have been submitted to us itsadministration distinctly effects an increase in the number ofred corpuscles and in the amount of haemoglobin. Our

analysis gave the following figures :-Alcohol by volume,18 25 per cent. ; total solid matters, 4° 39 per cent. ;mineral matter, 0-83 per cent., containing 0-44 of ferricoxide (Fe2Oa) and 0-13 per cent. of manganic oxide (Mn2O3).

ORIENTAL TOOTH PASTE.

(JEWSBURY AND BROWN, ARDWICK GREEN, MANCHESTER.)This tooth paste satisfies the requirements of an application

intended to keep the teeth scientifically clean. It containsa polishing agent, an antacid substance, and agreeable anti-septics chiefly in the form of aromatics. It is quite pleasantto use, is free from grittiness, and leaves a pleasantimpression in the mouth. Further, it has mild astringentproperties.

MARVIS FLAKES.

(MARVIS AND Co., 4, STARR-YARD, CAREY-STREET, LONDON, W.C.)We have examined this food preparation previously, but

recently a further improvement has been made, inasmuch asthe flakes are now prepared from fresh instead of saltedfish. The flakes are clean and white and contain all that is